Lung cancer often has no symptoms until it has spread (metastasized). This is because there are few specialized nerves (pain receptors) in the lungs. When lung cancer symptoms do occur, they vary depending on the type of lung cancer and location and size of the tumor.
Lung cancer screening with a low dose CT (LDCT) scan is the only proven method that can detect cancer earlier, before symptoms occur, when it is more treatable and even curable. Chest x-rays are not as effective.
Check out this short video from LCA Board Member, Jim Mulshine, MD, Rush University on the science of screening, why it’s so essential for those at high risk and what we can expect to see in the near future.
What You Need to Know about Lung Cancer Screening
If you are a current or former smoker, your risk of developing lung cancer may be as much as 25 times higher than someone who never smoked. A Computed Tomography (CT) scan is the only proven effective way to screen for lung cancer.
If you are at risk for lung cancer and considering being screened, it is important that you and your healthcare provider consider the benefits and risks before making an informed decision together.
Who Should be Screened for Lung Cancer?
Currently, lung cancer screening is recommended (and covered by most insurance plans and Medicare) for a specific high-risk population. Individuals who meet these criteria are at the highest risk, but there is ongoing research to determine who else may have an elevated risk of developing lung cancer.
Who should be screened:
- You are between the ages of 55-80.
- You have a 30 pack-year smoking history.
- (Calculated as # of packs smoked per day multiplied by # of years smoking. For example: 1 pack per day X 20 years = 20 pack years)
- You are a current smoker or quit within the past 15 years.
*The criteria above is recommended by the United States Preventive Services Task Force (USPSTF). If you do not meet the high risk criteria but are concerned you are at risk for lung cancer, talk with your doctor about whether screening is right for you.
What is screening?
Screening is testing with a CT scan which can identify small nodules or other abnormalities in your lungs. Finding a problem at an early stage, before there are symptoms, may make it easier to treat.
What are the benefits?
Studies have shown that screening those at high risk with CT scans before symptoms appear can find lung cancer early when it is easier to treat and more likely to be cured. In addition, lung cancer screening might also show if you have other conditions or diseases that need to be treated.
What are the risks?
Cancer screening tests are not perfect. Some cancers can be missed (false negative) and some may look like a cancer when they are not (false positive).
How often should I be screened?
Talk to your doctor about the results of your first screening to determine what you need to do next. For most people, a yearly scan is recommended.
Lung nodules, which are spots on the lung, are common. Some people screened will have a nodule that needs further testing. Most of these nodules will not be cancer and this will be determined by additional CT scans. A small number of nodules will need additional tests, such as other imaging tests, needle biopsy or surgery. Biopsies and surgery have other possible risks.
What about radiation?
You will be exposed to low levels of radiation during the test. This level of radiation is more than an x-ray but much lower than a regular CT scan that you might have if you have symptoms of cancer. To put it into perspective, you will receive about the same amount of radiation from six months in your natural environment.
Why should I get screened?
Once you have talked to your doctor about risks and benefits, it might be useful to talk about why you may or may not want to be screened. Some questions to consider include:
- What are my reasons for wanting to be screened?
- Would I undergo surgery and possible treatment should cancer be found?
- What are my reasons for not wanting to be screened?
- Do I have all the information I need to make a decision with which I feel comfortable? If not, what other questions can my doctor help answer for me?
- Do I need to talk with someone else about this decision besides my doctor? If so, who could help me make this decision?
It is important to consider all of the benefits and risks of lung cancer screening. Here are some other important things to consider:
- Screening is not a one-time test. In order for it to work, you have to come every year for as long as your doctor recommends, so that any cancer that may be small and slow growing will be found as early as possible.
- If you smoke, it is still important to consider quitting. You might think it doesn’t matter but there are lots of benefits to quitting, even now. Your healthcare team wants to help you! Don’t be afraid to ask for their help.
What should I expect when getting scanned?
Lung cancer screening is done using an imaging machine to produce a low-dose spiral (or helical) CT (Computed Tomography) scan of the chest. This scan uses a series of x-rays to show the shape, size and location of anything abnormal in the chest that might signal the need for follow up. CT scans are very sensitive and can show both cancerous and non-cancerous areas.
To get a CT scan, you will lie very still on a table, which is slowly moved through the CT scanner. An x-ray machine rotates around you and takes pictures from many angles. A computer then combines the pictures into a very detailed image. The procedure takes less than 30 seconds. There are no medications or injections needed and there is no need to stop eating or drinking before the exam. As long as your clothing does not contain metal, you may not even have to change. It is important, however, that you are able to hold your breath for several seconds. That way, your lungs will not move during the scan and the images will be clear.
Find a center committed to responsible screening near you.
What happens to the scan results?
The results from your lung cancer scan will be sent to the doctor who referred you for screening. Your doctor will review the results of the scan and will discuss if any follow up is needed. Because a spiral CT scan is so detailed, it is possible that something will show up on the exam that is not cancer. Your doctor will discuss the best way to follow up on any test result.
In the event that you were screened without a referral from a doctor, the screening center will provide you with your results and any appropriate follow up information.